visiting your GP
You’ll need to have an internal examination, to check the organs in your pelvis. This means lying on your back while the doctor puts one or 2 fingers inside your vagina and their other hand on your lower abdomen. Your doctor will press gently on your tummy and inside your vagina. It shouldn’t hurt but it may feel uncomfortable. You can have a friend or relative with you the whole time. If you’re on your own, a nurse will be with you while you have the examination.
at the hospital
If you need more tests you’ll be referred to a hospital. This could be a general hospital or a specialist cancer hospital. These are some of the tests you may need.
- Blood tests - to see whether or not chemicals called 'tumour markers' are being released into the bloodstream. The two main markers produced by germ cell tumours are AFP (alpha feta protein) and HCG (human chorionic gonadotrophin). They are used to help diagnose germ cell tumours and later, during treatment, to check how well treatment is working.
- Ultrasound scan - this uses sound waves to build up a picture of what’s happening inside you. They are commonly used to look at babies before they’re born. Some cold gel is put on your tummy then the ultrasound probe (which looks a bit like a small microphone) is rubbed on your tummy to get the picture of your ovaries. Sometimes it also helps if it’s gently put inside your vagina to get a clearer image from that angle. It’s not painful but might be uncomfortable. It’s important for you to have a friend or relative with you during this test. If you don’t want someone you know to be there, a nurse can be with you instead.
- CT (computerised tomography) scan - for this you need to lie inside a tunnel-like machine. Lots of x-rays are taken and fed into a computer to build up a detailed picture of the size and position of the tumour.
- Laparoscopy - a small cut is made in the skin (usually just above your pubic hairline) so that the doctor can put in a laparoscope (a very thin mini telescope). This helps your doctor to see your ovaries and the surrounding area. Sometimes, they can take out the affected ovary through this tiny cut. But more often they need to do an operation called a laparotomy.
